Ecology

We began this series with a 1999 report from the NEW YORK TIMES which said state governments in the U.S. are refusing to comply with a 1989 federal law requiring that children be tested for lead poisoning. Even at low levels, lead poisoning can reduce a child's IQ, impair hearing and stunt growth. Federal law requires all children enrolled in the Medicaid medical insurance program to be tested for lead poisoning at age 12 months and again at age 2 years. The federal government pays the costs of testing and subsequent treatment for any children found poisoned.

However, according to a 1999 study by the General Accounting Office (GAO), an investigative arm of Congress, state governments are simply refusing to comply with the law. As a result, the GAO said, hundreds of thousands of children exposed to dangerously high levels of lead are neither tested nor treated, the TIMES reported. (See REHW #687.)

We are seeking an answer to the question, "Why would governments set policies that continue to poison children?"

* * *

Childhood lead poisoning is not new. Medical reports of children poisoned by lead began to appear in the U.S. in 1914. By the 1930s, a torrent of information about the problem was appearing in medical journals.[1,2,3]

Prior to World War I, one obvious source of the problem had been clearly identified: lead-based paint applied to the walls, toys, and furniture in children's homes. Lead, the soft, gray toxic metal makes an excellent white pigment (to which other colors can be added) and leaded paints provide durable protective coatings. Nevertheless, as time passes, leaded paint dries out and begins to peel, flake and disintegrate into a toxic powder. As a result, toddlers can get toxic flakes or dust on their hands, then into their mouths.[4,5,6] Brain damage often follows.

Long before World War I this information was so widely understood that France, Belgium and Austria restricted the use of leaded paint in 1909. Tunisia, Greece and Australia took similar action in 1922, the same year the Third International Labor Conference of the League of Nations recommended a complete ban on leaded paint for indoor use. In 1924, Czechoslovakia restricted the use of lead paint; Great Britain, Sweden and Belgium followed suit in 1926; Spain and Yugoslavia in 1931; Cuba in 1934. The U.S. on the other hand took no action until 1970.[3]

How did the paint and lead industries react to the information that their products were poisoning children? Recently, as a result of a lawsuit, many internal documents from the paint and lead industries became public for the first time. Two historians, Gerald Markowitz and David Rosner, have summarized some of these documents in a remarkable history published last month in the AMERICAN JOURNAL OF PUBLIC HEALTH.[3]

To begin with, lead paint manufacturers acknowledged -- at least privately -- that lead was toxic. In 1921, Edward J. Cornish, president of the National Lead Company, manufacturer of the leading brand of lead-based paint, wrote to David Edsall, dean of the Harvard Medical School, saying that, as a result of "50 or 60 years" of experience, paint manufacturers agreed that "lead is a poison when it enters the stomach of man -- whether it comes directly from the ores and mines and smelting works"1 or from the finished forms of lead (carbonate of lead, lead oxides, and sulfate and sulfide of lead). As early as 1897 one paint manufacturer in New York City was advertising that "Aspinall's Enamel is NOT made with lead and is non poisonous."[7]

Within the paint industry, there were voices of prudence. In 1914 the director of the scientific section of the Paint Manufacturer's Association predicted that "lead poisoning will be done away with almost entirely"[1] because "sanitary leadless" paints had been developed.[3]

In truth, titanium and zinc substitutes for lead paint pigments had become readily available during the latter part of the 19th century, so there was never any compelling need for toxic lead-based pigments. However, lead was plentiful and profitable and its victims were not organized.

As the bad news about lead-based paint accumulated, the paint and lead industries took the offensive by using images of children in their advertising and sales promotions. Starting in 1907, the National Lead Company began to promote its "Dutch Boy White Lead Paint" using the image of a child on the label. Before 1920, National Lead was explicitly aiming its marketing and advertising at children. An ad in 1918 showed a little girl purchasing "Dutch Boy White Lead Paint." The ad recommended that paint merchants should "Cater to the children." It asked, "Have you stopped to think that the children of today are the grown-ups of tomorrow..." A 1920 ad -- headlined "Don't Forget the Children"

-- suggested that paint sales personnel should give gifts to children who visited their paint store accompanied by a parent. "Parents appreciate little attentions of this sort paid to their children," the ad said. In 1924, National Lead began promoting the use of lead-based paint in public schools.

The Lead Industry Association (LIA) was formed in 1928 to promote the use of lead. At that time, lead-based paint was the single biggest user of lead, though lead in gasoline was rising as well.

Acknowledging the poisoned-children problem, the LIA claimed it was urging toy and furniture manufacturers to avoid lead-based paints, but toy manufacturers who tested their products found them contaminated with lead-based paints. Someone was lying. For its part, National Lead -- the lead-paint industry leader -- was aggressively marketing lead-based paint to children. For example, the firm published a booklet for children in 1930, showing the Dutch Boy skipping along hand-in-hand with 2 children, then mixing white lead with colors and painting walls and furniture.

The booklet contained this jingle:

The girl and boy felt very blue
Their toys were old and shabby too,
They couldn't play in such a place,
The room was really a disgrace.
This famous Dutch Boy Lead of mine
Can make this playroom fairly shine
Let's start our painting right away
You'll find the work is only play.

Another promotion showed a crawling infant making hand-prints on a painted wall. The caption said, "There is no cause for worry when fingerprint smudges or dirt spots appear on a wall painted with Dutch Boy white-lead." Historians Markowitz and Rosner observe, "The explicit message was that it was easy to clean the wall; the implicit message was that it was safe for toddlers to touch woodwork and walls covered with lead paint."

In addition to using images of children to sell lead paint, National Lead emphasized that lead was healthy. Beginning in 1923, National Lead was advertising in NATIONAL GEOGRAPHIC that "lead helps to guard your health." Throughout the 1920s, National Lead advertised in MODERN HOSPITAL magazine, calling white lead paint "the doctor's assistant." The ads assured readers that walls covered with lead-based paint "do not chip, peel, or scale" -- an obvious falsehood.

The Lead Industry Association (LIA) promoted lead paint in a 1930 booklet: "White lead paint is widely used for home interiors." Accompanying illustrations showed several home interiors freshly-painted with lead.

There were warnings against such practices from within the lead industry. In 1933, Robert Kehoe, chief medical scientist at the Ethyl Corporation (which was at that time busy providing millions of tons of toxic lead to the nation's children via gasoline) urged in the JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION that "strenuous efforts must be devoted to eliminating lead from [children's] environment." Kehoe was specifically referring to lead-based paint.

Nevertheless, in 1938 the LIA began a multi-year nationwide "White Lead Promotion Campaign." The purpose of the campaign was to "dispel fear or apprehension" about using lead-based paint in your home. Three years later, in 1941, the secretary of the LIA, Felix Wormser, noted that the campaign was helping: "[I]n the long run [the campaign] will share in dispelling anxiety about [lead's] use. In any event the problem remains serious for our industry. Hardly a day passes but what this office has to devote some attention to lead poisoning," Wormser said.

In December 1943 TIME magazine reported on a medical study of children poisoned by lead-based paint used on toys, cribs and window sills. The result was permanently reduced IQ, with learning disabilities, among the children. Felix Wormser of the LIA took the offensive; in a response to the TIME article, Wormser claimed that the connection between lead poisoning in infancy and later mental retardation had never been proven. For the next 15 years this was the LIA's position -- permanent injury to children from sub-lethal lead poisoning had not been proven.

Wormser's position was insupportable. Robert Kehoe informed the head of the LIA that in his own work he had observed "serious mental retardation in children that have recovered from lead poisoning." Kehoe argued that Wormser's position was not consistent with the available facts: "Unfortunately for Wormser's thesis, comparable results [i.e., mental retardation] have been obtained in almost every other area of the United States where there have been facilities that enable accurate investigation of this type to be made," Kehoe wrote.

By the 1950s, the lead and paint industries both acknowledged that their products were poisoning children, and their defense took a new turn. In its 1959 annual report the LIA noted that "lead poisoning, or the threat of it, means thousands of items of unfavorable publicity each year."[8]

"This is particularly true," the LIA report continued, "since most cases of lead poisoning today are in children, and anything sad that happens to a child is meat for newspaper editors and is gobbled up by the public. It makes no difference that it is essentially a problem of slums, a public welfare problem. Just the same the publicity hits us where it hurts,"[8] the LIA report said, clearly implying that it SHOULD make a difference that only slum children were being poisoned.

This became the lead industry's main line of argument: lead only harmed slum children. In 1955 the LIA's director of health and safety went on record saying, "Childhood lead poisoning is common enough to constitute perhaps my major 'headache,' this being in part due to the very poor prognosis in many such cases, and also to the fact that the only real remedy lies in educating a relatively ineducable category of parents. It is mainly a slum problem with us." To summarize the Lead Industry Association's argument: The poisoning of children cannot be remedied because of parents who live in slums and cannot be educated. In short, lead poisoning is the parents' fault.

[1] Richard Rabin, "Warnings Unheeded: A History of Child Lead Poisoning," AMERICAN JOURNAL OF PUBLIC HEALTH Vol. 79, No. 12 (December 1989), pgs. 1668-1674. [Back to article]

[2] John C. Burnham, "Biomedical Communication and the Reaction to the Queensland [Australia] Childhood Lead Poisoning Cases Elsewhere in the World," MEDICAL HISTORY Vol. 43 (1999), pgs. 155-172.

[3] Gerald Markowitz and David Rosner, "'Cater to the Children': The Role of the Lead Industry in a Public Health Tragedy, 1900-1955," AMERICAN JOURNAL OF PUBLIC HEALTH Vol. 90, No. 1 (January 2000), pgs. 36-46. [Back to article]

[4] Howard W. Mielke and Patrick L. Reagan, "Soil Is an Important Pathway of Human Lead Exposure," ENVIRONMENTAL HEALTH PERSPECTIVES Vol. 106 Supplement 1 (February 1998), pgs. 217-229. [Back to article]

[5] Bruce P. Lanphear and others, "The Contribution of Lead-Contaminated House Dust and Residential Soil to Children's Blood Lead Levels," ENVIRONMENTAL RESEARCH SECTION A Vol. 79 (1998), pgs. 51-68.